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Central Referral Office Representative

6025868

Patient Navigation Hub

Melville
992 North Village Avenue Rockville Centre, NY 11570

Full Time

Day shift

9:00AM - 5:00PM

Centralized Referral Office Representative

Catholic Health Services of Long Island (CHS) is an integrated health care delivery system with some of the region's finest health and human services agencies. CHS includes six hospitals, three skilled nursing facilities, a regional home nursing service, hospice and a multiservice, community-based agency for persons with special needs. Under the sponsorship of the Diocese of Rockville Centre, CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping people live their final years in comfort, grace and dignity.

Centralized Referral Office Representative works with the Electronic Medical Records department (EMC) scheduling testing, procedures and referrals for CHSLI practices. Obtains pre­ certification prior authorizations for procedures, outpatient tests, and referrals. Position works closely with the practices and maintains strict confidentiality.

 Responsibilities:

  • Verifies insurance coverage and obtains prior authorization as needed. Communicates financial responsibility to the patient for referral, procedures, or consultation.
  • Provides customer service functions to include addressing patient, hospital and provider inquiries and complaints from all sources in a timely manner.
  • Works well with others and functions as a team player. Offers ideas and solutions for issues that affect the team and work area. Stocking and ordering of supplies as needed. Maintains patient care areas. Participates in the training and skills development of new front office employees. Assists in other areas of the office as necessary
  • Maintains a current knowledge of clinical operations including medical knowledge. This will be required to understand referral is requested by providers. Develops and maintains a working knowledge of CPT and CDI coding. Participates in continuing education. Participates in the development of new programs.
  • Ensure  that providers are notified using the (EMR) when a procedure, consultation, or result is complete and documentation is available for review by sending
  • Assists with special projects as needed.
  • Prepares productivity reports each month, including but not limited to calls, referrals, and amounts collected. Referral reporting is generated monthly and provided to Administration.  

Requirements:

  • High School Diploma or GED
  • Two years of related experience in a clinical environment.
  • Expert knowledge in surgical and procedural authorizations.

  • Ability to organize, analyze and prioritize work
  • Exhibit exceptional communication and negotiating skills to interact with payers, providers and patients
  • Data entry experience preferred. Business like appearance, detail oriented ability to multi-task, ability to work closely with others and function as a team member
  • Working knowledge of CPT and CD-9 coding required
  • Must possess the initiative and drive to take a project from beginning to a successful completion
  • Basic knowledge of medical terminology and anatomy required.

At Catholic Health Services of Long Island your well-being comes first, with comprehensive compensation and benefits; our offerings go beyond the basics. In addition to multiple medical plans, life insurance, generous paid time off and flexible spending accounts, we also offer substantial tuition reimbursement, an employer funded pension plan and several savings plan options for your future.